The work environments that I have experience with reflect the mixed team co-operative approach. Consequently, the task list does not always cover the needs of the patient. If patient wellbeing is the priority, then the highly motivated nursing team, would likely take a “see it needs to be done, then do it” approach to care falls naturally into place. If it is a skill that is beyond an RPN’s scope of practice, call in the RN. It seems so natural and clear, but from the history, the relationship appears fractured. Perhaps as the new generation of nurses come on board, the history can be changed because health care has changed, and so too has patient acuity & longevity. The RN needs the support and careful work of the RPN now and going forward.
High risk, acuity patient needs are addressed by the RN. However, the RPN assesses, monitors signs and symptoms of discomfort, distress, or that things seem “off” with a patient and then advise the RN of findings and s/sx observed and noted. Documenting observation & findings as well as the details provide to the RN are important.

In the setting that I work in there is no clear difference in the expectations of the RN’s and RPN’s being any different. We work together very well and divide the patient load well and evenly. The office I work for is primary care for family doctors under a family family health team organisation. There are no critical care patients that need specifically RN’s to assess or provide care to them. The nurses all provide the same care to the patients coming in to see their family doctor or to see the NP/PA we have on staff as well as seeing the nurses we have for our preventative care programs such as diabetic visits, prenatal care visits, smoking cessation visits, osteoporosis visits, and coming in to our treatment room in which the nurse gives vaccines, B12 injections, ear syringing, suture and staple removal, strep throat assessments and UTI assessments are just a few of the common appointments booked with the nurses and this goes for both the RN and RPN’s on staff we are all trained to do all of the tasks required.
I do understand that in a different setting like in a hospital there will be more defined roles and expectations between RN’s and RPN’s that would need to have certain patient loads or tasks given to the most responsible person for the individual needs and complexity of the care needed.
The idea of having a set list of tasks or delegations for either an RN or and RPN would not work in the setting that I work in because there are no tasks or patient load that can not be with an RPN versus and RN for severity of needs/or fragility of the patient status.

In my workplace, there is a big difference between NP and RPN. There are however many overlapping areas. We work well together, I think, as we have many of the attributes of high functioning teams. The Nurse Practitioner-Led Clinics are a very lean model of care, with a steep hierarchical structure, that, in this case, helps our “group perform better”. We each know are roles, and the roles of others. If there are areas that are more gray, we are open to review and discuss. As NP’s, we are always available if things are more gray. Our team is very patient-focused, with the appropriate nurse in the appropriate position, in a fairly flat (i.e. non-hierarchical) structure. We are always working “as a team”, and RPNs are rarely the sole provider in the clinic, and if they are, they are aware of who to reach out to if they have an issue or concern. We are always encouraging increasing knowledge-base and open to educational pursuits.

I love the article this week. It validates that we are a high functioning nurse team!

While I understand the desire for a list, I don’t think it can capture the difference between RPN and RN roles. In my experience, both RPNs and RNs provide nursing care and use knowledge, skill, and judgment. There is a lot of overlap in roles, especially in settings where patients are stable and outcomes are more predictable.

To me, the difference is more about the depth and breadth of knowledge behind the role. RN education has more focus on clinical decision-making, critical thinking, leadership, health care systems, and resource management. Because of this education, the RN role may be better positioned for responsibilities related to care coordination, clinical leadership, supporting the team when a patient’s condition becomes more complex, and considering broader system or resource needs.

However, this does not mean RPNs cannot contribute to these areas. The roles overlap, and how they are used depends on the patient, the nurse, and the practice setting.